OBJECTIVES : This analysis estimated and compared long-term Cost Per Responder (CPR) based on the ASAS outcomes following 52 weeks treatment for ankylosing spondylitis (AS) with Secukinumab (SEC), compared to Adalimumab (ADA) and Infliximab (INF) for Greek NHS

METHODS

: Analysis is based on a matching-adjusted indirect comparison (MAIC). CPR calculated using long-term response rates from MAIC based on MEASURE 2, ATLAS & ADEPT RCTs. The CPR was estimated by dividing drug acquisition cost for the course of treatment with its response rate. Drug costs were based on December 2017 price bulletin and the number of doses required for 52 weeks. (infliximab administration cost also estimated).

RESULTS : MAIC showed that ASAS response rates were significantly higher for SEC compared to ADA at 52 weeks. ASAS20 response rates were 81% vs 65%, ASAS40 response rates were 62% vs. 47% and ASAS5/6 response rates were 72% vs. 55% for SEC and ADA, respectively. The CPR for ASAS20 responders were €7,073 vs. €10,139, for ASAS40 responders were €9,195 vs. €14,096 & for ASAS5/6 responders were €7,918 vs. €12,061 for SEC and ADA, respectively. The CPR for ASAS20/40/5/6 responders were 34%/38%/38% lower, respectively, for SEC compared to ADA. ACR20 response rates were 91% vs. 69% & ASAS5/6 response rates were 33% vs. 23% for SEC and INF, respectively. CPR for ACR20 responders were €6,298 vs. €16,046 & for ASAS5/6 responders were €17,281 vs €47,746 for SEC and INF, respectively. Sensitivity analyses confirmed results robustness.

CONCLUSIONS : The CPR for all ASAS outcomes at 52 weeks were consistently lower for SEC vs. ADA and INF, leading to important savings for Greek Social Security Fund . These findings indicate that may be more efficient treat AS biologic naive patients in Greece with SEC vs. ADA or INF. A potential weakness is that the comparison between drugs is indirect and based on a statistical model.